A. DESCRIPTION OF THE CENTER OVERALL A.1 STRUCTURE AND FOCUS. In response to RFA DE-08-008, the American Indian/Alaska Native Programs (AIANP) within the School of Medicine (SOM) and the School of Dental Medicine (SODM) at the University of Colorado at Denver and Health Sciences Center (UCDHSC), with our collaborating partner, the University at Buffalo SODM, propose a Center for Research to Reduce Disparities in Oral Health (CRRDOH), to be funded by the NIDCR as a Cooperative Research Center (U54). Other higher education institutions with which we have established relationships focused on recruiting students for potential careers in oral health disparities research include Fort Lewis College, which has a mandate to serve American Indian and Alaska (AI/AN) students; and several tribal colleges, including Sinte Gleska University on the Rosebud Reservation in South Dakota, Oglala Lakota College at Pine Ridge, and Dine College of the Navajo Nation. The Pine Ridge Department of Health Administration and the Pine Ridge Indian Health Service (IHS) Unit have worked with us to develop Research Component 1 (RC1). The Albuquerque Area Service Unit of the IHS will participate in RC2; the Talihina Service Unit (Oklahoma/Choctaw Nation) may also take part. The Navajo Nation Departments of Dine Education and Head Start are expected to participate in RC3. The Colorado School of Public Health Initiative, which includes programs offered jointly by the University of Colorado, Colorado State University, and the University of Northern Colorado, will work with us as well, particularly in the development of new training and career opportunities. Note: Please see Appendix RPAC-1 for abbreviations used in this application. Although disparities exist for other groups, the poor health status of AI/ANs is unparalleled in many respects. Life expectancy is almost 6 years less than for the general population and both morbidity and mortality are higher for a broad range of diseases and health problems, including diabetes, tuberculosis, pneumonia, and some forms of cancer.1 Oral infections (caries and periodontal disease) and their sequelae, such as edentulism, also are significantly higher among AI/ANs than among the general population.2 As evidence builds to substantiate a link between oral health status and systemic health conditionse.g., periodontal disease and diabetes, the seriousness of these disparities is compounded. The center proposed here will be known as the Center for Native Oral Health Research (CNOHR) and will focus on oral health disparities among AI/AN populations. (The term "American Indian and Alaska Native" or "AI/AN" will refer in this application to those who trace their origins to the indigenous peoples of the continental US; "Native" is used synonymously with AI/AN. See Appendix RPAC-1 for glossary of abbreviations.) The initial program of research will address the 2 most common oral infections, caries and periodontal disease, and will do so within the context of salient patterns of comorbidities, or oral-systemic connections. Special attention will be given to behavioral and social factors that influence and constitute risk factors for oral health across the lifespan. To ensure the development of culturally sensitive interventions that will be accepted and promoted by AI/AN communities, tribes and communities that have been invited to participate in intervention studies have been, and will continue to be, engaged in planning and dissemination of those interventions. In addition to building on the current research base to develop and conduct interdisciplinary intervention research that will lead to changes in health care policies, practices, and ultimately oral health, CNOHR will develop training opportunities, with the goal of cultivating a self-sustaining critical mass of scholars who are prepared to address the disparities identified here. CNOHR also offers the experience and commitment necessary to develop the enduring community relations and support essential for working in the sometimes politically charged context of research with tribal and other AI/AN communities/organizations. Finally, CNOHR will serve as a national resource to encourage and support collaborative research, research training, information dissemination, and technical assistance to the larger AI/AN oral health community. By extending opportunities for research development and support to other health disparities investigators, CNOHR will enhance capacity for research dedicated to improving the oral health of America's First Peoples.